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W or k - Re la t e d I n j u r y / I lln e ss Ca se M a n a g e m e n t Pr oce d u r e ( TSP- 2 1 )

For Cont ract or Com m unicat ion

Thailand Pr ofit Cent er

Mar ch 2011

© 2011 Chevron Corporation. All rights reserved.

Case Managem ent - Pur pose and Obj ect ives

 To ensur e t hat appr opr iat e m edical t r eat m ent is pr om pt ly pr ov ided t o t he inj ur ed / ill per son

To ensur e appr opr iat e follow up on cases unt il t he inj ur ed / ill

per son is fit for r et ur ning t o w or k

To ensur e effect ive coor dinat ion and com m unicat ion bet w een super v isor and affect ed Managem ent Per sonnel of t he inj ur ed/ ill per son, CTEP’s OE/ HES Depar t m ent , CTEP Medical st aff, along w it h m anagem ent of cont ract or com panies, 3 r d Par t y Cont ract ed Medical Ser v ices, and Tr eat ing Doct or s in onshor e clinics or hospit als

To ensur e inj ur ies or illnesses ar e classified in an accurat e and consist ent m anner accor ding t o t he Chev r on OE Dat a Requir em ent s w it h no int ent ion t o lim it t he t r eat m ent t o suit t he case definit ions.

Case Managem ent - Scope

The pr ocedur e is applicable t o all w or k- r elat ed inj ur ies or illnesses affect ing all em ployees and Cont ract or per sonnel w or k ing under Chev r on Thailand Ex plorat ion and Pr oduct ion, Lt d. ( CTEP)

Operat ional Cont r ol at all onshor e and offshor e locat ions, including t he Bangkok office.

I nit ial Tr eat m ent Facilit y for Wor k - Relat ed I nj ur ies/ I llnesses

 All w or k- r elat ed inj ur ies/ illnesses r efer r ed t o an onshor e hospit al for

t r eat m ent by a Chev r on Doct or or Medic w ill init ially be sent t o only t he follow ing designat ed hospit als:

•Bangkok- Hat yai Hospit al, Songk hla

•Bangkok - Pat t aya Hospit al, Chonbur i

• Nak har in Hospit al, Nakor n Sr i Tham m arat

•Vibhavadi Hospit al, Bangkok

I n cases w her e a w or k- r elat ed inj ur y or illness occur s at onshor e locat ions away fr om t he designat ed hospit als, e. g., inj ur y r elat ed t o m ot or vehicles, considerat ion should alway s be given t o use t he near est hospit al available,

depending on locat ion of incident and t he sever it y of inj ur y or illness.

Cont ract or s w ishing t o use anot her hospit al ot her t han t he appr oved Chev r on designat ed hospit als w ill be consider ed on a case- by- case basis

aft er discussion and appr oval fr om CTEP Healt h and Medical Ser v ices ( H&MS) Depar t m ent .

Follow - up Tr eat m ent Facilit y for Wor k- Relat ed

In j ur ies/ I llnesses

 Aft er an init ial diagnosis and t r eat m ent , a cont ract com pany m ay t ransfer an I nj ur ed/ I ll Per son ( I P) t o anot her hospit al for fur t her t r eat m ent and follow up w it h concur r ence fr om t he Chev r on on dut y Medical Doct or and r elevant Chev r on Depar t m ent al Manager. The I P’s em ployer m ust coor dinat e w it h t he Chev r on H&MS st aff in pr ov iding t he I P’s st at us on a daily basis unt il

t r eat m ent is concluded or t he I P is dischar ged fr om t he hospit al. A m edical cer t ificat e or dischar ge sum m ar y should be obt ained and sent t o Chev r on H&MS.

I f t he I P is due t o go off dut y and t he inj ur y / illness has not com plet ely

healed or a full r ecover y m ade, t he super v isor of t he I P shall consult t he Chev r on H&MS on dut y Doct or w ho m ay r ecom m end t hat t he per son r em ain w it h pay at an onshor e facilit y w hich has access t o a m edical facilit y.

 I n any case w her e t he I P is r eleased t o go hom e w it h m edical pr ecaut ions, t he I P m ust st r ict ly follow t he m edical inst r uct ion given.

Follow - up Tr eat m ent Facilit y for Wor k- Relat ed

In j ur ies/ I llnesses

 To r et ur n t o w or k, t he com pany r epr esent at ive m ust pr esent t he

r et ur n t o w or k or final m edical cer t ificat e r eceived fr om t he t r eat ing hospit al/ clinic t o t he Chev r on H&MS ( Sat t ahip, Songk hla, Nakor n Sr i Tham m arat or Bangkok ) for evaluat ion at least 3 w or k ing day s pr ior t o r et ur ning t o w or k . Medical decisions on fit ness for dut y w ill be

m ade by t he Chev r on on dut y Medical Doct or only.

CTEP Medical Per sonnel and Thir d Par t y Medical Ser v ice Pr ov ider Per sonnel

 For any t r eat m ent t hat is likely t o go beyond fir st aid, t he Facilit y Medic shall consult w it h t he Chev r on on dut y Medical Doct or. I f t he Facilit y Medic is under a t hir d par t y m edical ser v ice pr ov ider, t he Cont ract Medic shall consult w it h t he t hir d par t y Medical Ser v ice Pr ov ider Doct or w ho w ill cont act and discuss t he t r eat m ent opt ions w it h t he Chev r on on dut y Medical Doct or.

I n t e r a ct ion b e t w e e n CTEP M e d ica l Pe r son n e l a n d Tr e a t in g D oct or ( s)

Com m unicat ion bet w een Chev r on m edical per sonnel and Tr eat ing Doct or s is cr it ical,

and it m ust be done in a pr ofessional and et hical m anner. Aut hor it y and decision t o t r eat an I P lies w it h Tr eat ing Doct or s w it h t he concur r ence of t he inj ur ed/ ill per son; how ever, Chev r on m edical per sonnel m ay consult w it h Tr eat ing Doct or s t o ensur e consist ent case m anagem ent .

To avoid confusion and m isunder st anding, no one ot her t han assigned Chev r on m edical

per sonnel shall int er fer e w it h Tr eat ing Doct or s. Cont ract or s’ r epr esent at ives or 3r d par t y m edical ser v ice pr ov ider shall consult t he Tr eat ing Doct or s t hr ough Chev r on assigned m edical per sonnel.

Role and Responsibilit ies – All Em ployees and Cont ract or s

Not ify super v isor im m ediat ely and seek pr om pt m edical at t ent ion

follow ing an inj ur y or suspect ed w or k- r elat ed inj ur y or illness

Pr ov ide an accurat e descr ipt ion of t he suspect ed w or k- r elat ed inj ur y

or illness t o super v isor and m edical pr ov ider

Pr ov ide an accurat e descr ipt ion of any concur r ent m edical condit ions and/ or t r eat m ent s t o m edical pr ov ider

Adher e t o t r eat m ent pr escr ibed, w or k r est r ict ions, and com m unicat ion r equest s of Tr eat ing Doct or / Medic

Com plet e Per m ission t o Release I nfor m at ion For m

Role and Responsibilit ies – Super v isor of

I ll/ I nj ur ed Per son

Repor t k now n w or k- r elat ed inj ur y / illness case accor ding t o incident not ificat ion and invest igat ion pr ocedur e

I f t he case involves a cont ract em ployee, ensur e t he Cont ract Com pany Repr esent at ive has been not ified.

Not ify HR t o keep a r ecor d of t he indiv idual’s work- r elat ed inj ur y / illness, including sick leave, com pensat ion, et c.

Discuss w it h CTEP Doct or t o assign appr opr iat e dut ies t o t he I P follow ing appr oval for r et ur n t o w or k .

Role and Responsibilit ies – Manager of t he I ll/ I nj ur ed Per son

 Coor dinat e w it h t he Facilit y Medic and ar range necessar y m edical t ranspor t at ion ar rangem ent s

Ensur e appr opr iat e r esour ces ar e allocat ed t o m anage t he case upon not ificat ion of w or k r elat ed- inj ur y / illness

 Com m unicat e t o all per sonnel at t he facilit y t hat a Dr ug & Alcohol t est m ay

be conduct ed on t he I P and any ot her per sonnel dir ect ly involved in t he incident in w hich t he I P is r efer r ed t o an onshor e m edical facilit y

Rev iew fact s w it h Facilit y Medic or w it h Chev r on on dut y Medical Doct or or 3 r d Par t y Medical Doct or im m ediat ely follow ing diagnosis and t r eat m ent for

all w or k- r elat ed inj ur y / illness cases t hat have t he pot ent ial t o r esult in any w or k r est r ict ions

Rev iew Wor k Rest r ict ions or Fit t o Ret ur n t o Wor k st at us w it h Chev r on on

dut y Medical Doct or and super v isor of t he I P. Not ify t he next level of

m anagem ent of any I P w hose inj ur y / illness m ay r esult in w or k r est r ict ions

Suppor t t he assignm ent of appr opr iat e dut ies t o t he I P follow ing appr oval for Ret ur n t o Wor k w it h adv ice fr om t he CTEP Doct or

Roles & Responsibilit ies - 3 r d Par t y Medical Ser v ices Doct or

 Cont act t he Chev r on on dut y Medical Doct or t o discuss t he pr oposed init ial t r eat m ent befor e adv ising t he Facilit y Medic at t he offshor e locat ion

Adv ise 3 r d par t y Medic on diagnosis and t r eat m ent in w r it ing. The only except ion t o t his w ould be an em ergency sit uat ion, or if t her e is an I T com m unicat ions br eak dow n ( e- m ail) . I n t his case, ver bal com m unicat ions

fr om t he Doct or is accept able, but m ust be docum ent ed and for war ded once com m unicat ions have been est ablished

I f r e q u ir e d , coor d in a t e ca se m a n a g e m e n t w it h t h e h osp it a l Tr e a t in g D oct or on sh or e t h r ou g h t h e Ch e v r on On sh or e M e d ica l Coor d in a t or on ly ( n o d ir e ct con t a ct w it h Tr e a t in g D oct or )